Provider Demographics
NPI:1083320287
Name:URBANIK, FAITH MARIE (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:MARIE
Last Name:URBANIK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 N ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2309
Mailing Address - Country:US
Mailing Address - Phone:847-477-6089
Mailing Address - Fax:
Practice Address - Street 1:500 COVENTRY LN STE 170
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7592
Practice Address - Country:US
Practice Address - Phone:815-356-2700
Practice Address - Fax:815-356-2709
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist